AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 4; In this Issue
CHANGES TO THE ICD-10-PCS OFFICIAL GUIDELINES FOR CODING AND REPORTING
A summary of the modifications to the ICD-10-PCS Official Guidelines for Coding and Reporting is included below. The complete guidelines may be downloaded by visiting https://www.cms.gov/medicare/icd-10/2021-icd-10-pcs. The modifications are published below using the following format: Narrative changes appear in bold text (e.g., a more definitive root operation). Items underlined were moved within the guidelines since October 1, 2020 (e.g., control of acute bleeding). Deletions are shown as strikeouts (e.g., any of the definitive root operations). Medical and Surgical Section Guidelines (section 0) B3. Root Operation . . . B3.1b Exceptions: Mastectomy followed by breast reconstruction, both...
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Article Overview
This article is a summary of modifications to the ICD-10-PCS Official Guidelines for Coding and Reporting. It is useful for hospital coders, coding educators, auditors, and compliance staff who need to understand what changed in the ICD-10-PCS guidance for the referenced year. The content covers narrative edits, moved text, and deletions in the Medical and Surgical section, along with guidance related to root operations, sequencing of excision or resection with replacement, and approach assignment issues involving percutaneous endoscopic procedures.
Why This Topic Matters
ICD-10-PCS guideline updates can affect how inpatient procedures are reported and reviewed. Understanding the nature of the changes helps coding teams stay aligned with current official guidance and maintain consistent facility coding practice.
Article Sections
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Medical and Surgical Section Guidelines (section 0)
Introduces the guideline changes within the Medical and Surgical section. This section provides the context for the updated narrative text and moved or deleted material.
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B3. Root Operation
Covers updates to root operation guidance within the guidelines. The discussion includes exceptions and clarification language affecting procedure classification.
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B3.18 Excision/Resection followed by replacement
Addresses guidance when an excision or resection is followed by a replacement procedure. The section includes broad examples illustrating how the guideline text was updated.
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B5. Approach
Summarizes changes to approach-related guidance in the Medical and Surgical section. The focus is on percutaneous endoscopic procedures and related wording updates.
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B5.2b Percutaneous endoscopic approach with extension of incision
Explains the guideline language addressing procedures performed with a percutaneous endoscopic approach when an incision is extended to assist completion of the procedure. Broad examples are included in the source article.
What You Will Learn
- What parts of the ICD-10-PCS Official Guidelines were modified
- How the article organizes narrative changes, moved text, and deletions
- Which guideline areas were affected in the Medical and Surgical section
- How the article frames updated guidance on root operations and approach reporting
- What types of procedure scenarios are used as broad examples in the guideline summary
Who Should Read This
- Inpatient coders
- Coding educators
- Coding auditors
- Compliance staff
- Revenue cycle professionals
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